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KCEMS Protocol Study Guide 2021

  1. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-What is the definition of Level I treatments? Page no longer found***
    NO BASE CONTACT NEEDED
  2. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What are the requirements for Level II treatments? (Page no longer found)***
    Make base contact. Continue if radio failure.
  3. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Level I Treatment (page no longer found)***
    • Start IV and Administer fluids***
    • glucometer, capnography, and capnometry
  4. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What should you consider in all unresponsive patients? older question***
    Narcan, blood glucose analysis and Dextrose (if hypoglycemic) in all unresponsive patients including cardiopulmonary arrest***
  5. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What are the Level II protocols? Older question***
    • Cricothyrotomy
    • Thoracic decompression
    • Administer 9 additional drugs
  6. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What are Paramedics authorized during inter-facility patient transfers? Pg.4***
    Monitor IV’s of Potassium Chloride with less than 40 mEq, per liter ***
  7. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- LEVEL II PARAMEDIC PROCEDURES - Cricothyrotomy Comments*** pg 4
    May only be utilized if ventilation attempts by all other means are unsuccessful. Division approved device is a 10g IV catheter. (MAY HAVE BEEN REMOVED OR MOVED)
  8. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-DESTINATION DECISION - What is considered a significant ED OVERLOAD SCORE?*** pg 5
    Greater than 5 (Step 4)
  9. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- DESTINATION DECISION Trauma - Step 1 or 2*** pg 6
    KM
  10. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- DESTINATION DECISION STEMI*** pg 5
    • BMH
    • Heart
    • AH-B (Adventist Health – Bakersfield)
  11. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- DESTINATION DECISION Sexual Assault***pg 7
    AH-B (Adventist Health – Bakersfield)***
  12. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Pulseless Arrest (104) - The pause in chest compressions to check the rhythm and pulse should be no longer than how many seconds?*** pg 22
    10 seconds
  13. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- V-Fib / V Tach (125)- The pause in chest compressions to check the rhythm and pulse should be less than how many seconds?*** pg 76
    10 seconds
  14. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- V-Fib / V Tach (125)- For a cardiac arrest patient in VF/VT who has a body temperature of (<86oF), How many defibrillation(s) attempt are appropriate?*** pg 76
    One***
  15. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CPR PEA Which of the H’s and T’s in PEA is most common?*** (old question, no page found)
    Hypovolemia(most common)***
  16. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- TACHYCARDIA WITH A PULSE (123)- What is the treatment sequence for a stable patient with a wide QRS and a regular rate?*** pg 69
    GIVE LIDOCAINE 1-1.5 mg/kg IV/IO, may repeat @0.5-.075 mg/kg every 5-10 minutes to a MAX dose of 3mg.
  17. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- TACHYCARDIA WITH A PULSE (123) - What is the treatment sequence for a stable patient with a narrow QRS *** pg 69
    Vagal maneuver if no change, then Adenosine 6mg, 12mg,12mg max of 30mg
  18. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- TACHYCARDIA WITH A PULSE (123) - What should you do if the patient is unstable and conscious and you need to cardiovert?*** pg 70
    Provide sedation to a conscious patient if possible, but do not delay cardioversion if the patient is unstable.***
  19. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- BRADYCARDIA (106) -What should the starting pace rate be?*** pg 28
    80***
  20. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  BRADYCARDIA (106) - What dose of Atropine should you give?*** pg 26
    0.5MG IV. MAY REPEAT TO A TOTAL DOSE OF 3 MG
  21. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  BRADYCARDIA (106) - When should you start TCP immediately?*** pg 27
    No response to atropine***
  22. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEST PAIN/ACUTE CORONARY SYNDROME (110)- What is the maximum time to obtain a 12-lead ECG?*** Could not find page reference
    Do not delay treatment or transport beyond 2-3 minutes to obtain 12-lead ECG***
  23. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  CHEST PAIN/ACUTE CORONARY SYNDROME (110) - If the patient has taken their own aspirin and still are having Chest Pain, can you give them aspirin?** Pg. 39
    No, only if they haven't already taken some.
  24. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- PREMATURE VENTRICULAR CONTRACTIONS - What should you do with PVC’s in bradycardia or heart blocks?***old question
    • PVC’s should not be suppressed in bradycardic rhythms***
    • (Could not find in All Provider Policies Rev 2-16-21 )
  25. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-   ACUTE STROKE/CVA - Apply oxygen only if pulse ox is less than what %? pg 66
    94%
  26. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- ACUTE STROKE/CVA - What position should you transport a stroke patient?*** pg. 66
    Semi-Fowler’s position with no more than 30 degrees head elevation***
  27. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- PEDIATRIC PULSELESS ARREST/ENTRY ALGORHITHM - Should you allow the family to remain present during resuscitation?***old question
    Consider allowing the family to remain present during resuscitation. Studies show that family members who were present believe their presence was beneficial to the patient. Studies also suggest that family members present during resuscitations have less anxiety and depression and more constructive grieving behavior.***
  28. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  How should you deliver low energy shocks during Cardioversion? Old question no page found
    Low energy shocks should always be delivered as synchronized shocks. Low energy unsynchronized shocks (defibrillation) are likely to induce VF. If cardioversion is needed and it is not possible to synchronize a shock, use unsynchronized shocks (defibrillation) at defibrillation doses.
  29. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- PEDIATRIC VF/PULSELESS VT (125) -The pause in chest compressions to check the rhythm and pulse should not exceed how many seconds?***pg 76
    10 seconds***
  30. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  PEDIATRIC VF/PULSELESS VT (125)- What should you do for a cardiac arrest patient in VF/VT who has a body temperature of <30oC (<86oF)?***pg 77
    A single defibrillation attempt is appropriate. If the patient fails to respond to the initial defibrillation attempt, defer subsequent attempts and drug therapy until the core temperature rises above 30oC (86oF).***
  31. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- NEONATAL RESUSCITATION (115) - What is the recommended ratio for compressions to ventilations?***pg 49
    3:1 with 90 compressions and 30 breaths to achieve 120 events per minute***
  32. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- BURNS (108) - How do you treat burns to large body surface areas?*** pg 33
    They should be cooled initially to stop burning process and then wrapped in dry, sterile dressing to prevent hypothermia***
  33. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- COMBATIVE PATIENT RESTRAINT (205) - How should Restraints should be secured?***pg 70
    To a non- moving part of a gurney and tied in a fashion that will allow for quick release***
  34. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- POSTPARTUM HEMORRHAGE - Postpartum hemorrhage is characterized by? *** OLD QUESTION
    Acute blood loss of (Greater than) >500 mL after delivery of the newborn***
  35. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  RESPIRATORY COMPROMISE-ADULT (120) - What is indicated with minor to moderate cases of bronchospasm not responsive to albuterol?***pg 60
    Epinephrine 1:1000 0.3 MG, IM or IV OR Push Dose 0.5ml every 1-5 minutes OR Drip 2-8mcg/minute Start at 2mcg
  36. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- RESPIRATORY COMPROMISE-ADULT (120) - What can be administered to reduce myocardial workload and oxygen consumption in cases of pulmonary edema?*** pg 60
    • Nitroglycerin 0.4 MG SL  Repeat every 5 minutes as long as BP > 100 SYSTOLIC
    • CONSIDER CPAP IF AVAILABLE AND BP > 90 SYSTOLIC
  37. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  HEAD/EYE/EAR/ TRAUMA (113) - What are the signs of Cushing’s Triad?*** pg 45
    • Decreased heart rate
    • Increased blood pressure
    • Increased respiratory rate.
  38. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-  HEAD/EYE/EAR/ TRAUMA (113) -  What is the goal for blood pressure?*** pg 44
    Greater than 80 systolic.***
  39. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- SHOCK/HYPOPERFUSION(124) - what medication do you administer for Trauma and Post-Partum Hemmorhage? pg 73
    Consider Tranexamic Acid 1 gram administered over 10 minutes for the initial dose. Mix 1 gram (10 mL) in 100 mL of NS and infuse via: - Macro 10gtts/mL over 10 minutes @ 110 gtts.
  40. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-TRAUMATIC CARDIAC ARREST(126) - What should you do if you suspect a possible TENSION PNEUMOTHORAX? pg 80
    Tension pneumothorax requires immediate decompression
  41. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- 12-LEAD EKG (201) - What should you do if the monitor indicates "ACUTE MI”*** pg 84
    CONTACT A STEMI RECEIVING CENTER WITHIN 5 MINUTES OF ACQUISITION AND ADVISE “STEMI ALERT”***
  42. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- 12-LEAD EKG (201) - What shall be the trigger for the notification of a “STEMI Alert? pg 87
    The monitor’s interpretation, on the printed 12 Lead EKG
  43. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-12-LEAD EKG (201) - Who receives a copy of the 12 lead EKG? pg 87
    • A copy must be maintained by the transporting agency
    • The hospital ED for inclusion in the patient chart. The 12 lead EKG print-out shall be presented to hospital staff at the time the patient is delivered.
    • A copy made available to EMS upon request
  44. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) - What criteria must be met?*** pg 88
    • AGE >8 YEARS OLD
    • PATIENT ALERT, ORIENTED, AND ABLE TO FOLLOW COMMANDS
    • PATIENT HAS THE ABILITY TO MAINTAIN AN OPEN AIRWAY (GCS>10)
    • SYSTOLIC BP > 90MMHG
  45. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) - What are the four signs and symptoms that two must be present?***pg 88
    • RESPIRATORY RATE > 25 BREATHS PER MIN
    • RETRACTIONS OR ACCESSORY MUSCLE USE
    • PULSE OXIMETRY <94%
    • ADVENITIOUS (ABNORMAL) OR DIMINISHED LUNG SOUNDS
  46. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) -What are the five signs and symptoms that must be absent?*** pg 88
    • AGONAL OR ABSENT RESPIRATIONS
    • SUSPECTED PNEUMOTHROAX OR PENETRATING CHEST TRAUMA
    • PATIENT HAS TRACHEOSTOMY
    • SYSTOLIC BP OF <90 mmhg RISK FOR ASPIRATION (VOMITING, EPISTAXIS, FACIAL TRAUMA)
  47. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) -What is a more important factor than the age in determining eligibility for CPAP? Pg 89
    The size and anatomy of the patient
  48. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) -***- Which patients may receive CPAP? pg 88
    CPAP is approved for use on adults and children eight (8) and older. CPAP is indicated for patients who are alert, oriented, and able to follow commands. Patient must have the ability to maintain an open airway (GCS>10). BP must be above 90 systolic. Additionally two (2) of the following must exist: Respirations above 25/min; retractions or accessory muscle use; pulse ox <94%; abnormal or diminished lung sounds.
  49. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) - How often must vital signs must be recorded?*** pg 90
    Every 5 minutes
  50. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) - What vital signs must be recorded? pg 90
    • Respiratory rate
    • Heart rate
    • Blood pressure
    • Sp02
  51. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-CONTINUOUS POSITIVE AIRWAY PRESSURE (202) -Can a CPAP patient be transferred to a Paramedic that has not been trained on the use of CPAP? pg 90
    NO
  52. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-SPINAL MOTION RESTRICTION (204) - Who receives spinal immobilization?*** pg 95
    • Posterior midline spinal pain or tenderness with a history of or suspicion of trauma.
    • Numbness or weakness in any extremity after trauma.
    • Injuries distracting patient from distinguishing spinal pain (e.g., pelvic fracture, multi-system trauma, crush injury to hands or feet, long bone fracture proximal to the knee/elbow, or to the humerus/femur.)
    • Altered Mental Status GCS <15.
    • Intoxication.
    • Language Barrier, unless reliable translation is available.
    • Age less than 3 or greater than 65.
  53. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-SPINAL MOTION RESTRICTION (205)- Does mechanism of injury alone determine spinal immobilization?***pg 96
    No***
  54. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-SPINAL MOTION RESTRICTION (204)- What does Complete spinal motion restriction include? pg 96
    cervical collar (C-Collar) and gurney straps or seatbelts only. Head blocks may be used to prevent rotation.
  55. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) – Treatment for a mild exposure? Pg 35
    • ADULT: DUODOTE OR MARK I KIT X1 IM (MAY REPEAT FOR TOTAL OF 3 IF SYMPTOMS PROGRESS)
    • PED: DUODOTE OR MARK 1 KIT IM
    • UP TO 25KG: 1 KIT
    • 26-50KG: 1 KIT MAY REPEAT X1
  56. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) – Treatment for a mild exposure if no Duodote or Mark 1 kits are available? Pg 35
    • ADULT -ATROPEN IM, MAY REPEAT EVERY 5 MIN TO MAX OF 6MG
    • PEDIATRICS -ATROPEN IM
    • <4KG: 0.5MG REPEAT 0.5MG
    • 4- 10.5 KG: 0.5MG REPEAT 1MG
    • 10.5-13KG: 1MG REPEAT 1MG
    • 13-20.5KG: 1MG REPEAT 2MG
    • 20.5-33KG: 1.5MG REPEAT 4 MG
    • 2PAM CHLORIDE 25MG/KG IM/IV X1. MAX OF 1650MG IM OR 1000MG IV
  57. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) –  Treatment for a moderate exposure? Pg 35
    • ADULT: DUODOTE OR MARK I KIT X2 IM (MAY REPEAT FOR TOTAL OF 3 IF SYMPTOMS PROGRESS)
    • PED: DUODOTE OR MARK 1 KIT IM
    • UP TO 25KG: 1 KIT
    • 26-50KG: 2 KITS
  58. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) – Treatment for a moderate exposure if no Duodote or Mark 1 kits are available? Pg 35
    ADULT ATROPEN IM, MAY REPEAT EVERY 5 MIN TO MAX OF 6MG

    • PEDS ATROPEN IM
    • 4KG: 0.5MG REPEAT 0.5MG
    • 4- 10.5 KG: 0.5MG REPEAT 1MG
    • 10.5-13KG: 1MG REPEAT 1MG
    • 13-20.5KG: 1MG REPEAT 2MG
    • 20.5-33KG: 1.5MG REPEAT 4 MG
    • 2PAM CHLORIDE 25-50MG/KG IM/IV X1. MAX OF 1650MG IM OR 1000MG IV
  59. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) – Treatment for a severe exposure? Pg 35 & 36
    • ADULT: DUODOTE OR MARK I KIT X3 IM
    • Valium 10 mg IM or Versed 2-5 mg IV for Seizure control. 5 mg IN or IM if no IV. (repeat X 1 in 5 minutes to max of 10 mg.
    • PED: DUODOTE OR MARK 1 KIT IM
    • UP TO 25KG: 1 KIT
    • 26-50KG: 2 KITS
    • Valium 0.05-0.3 mg/kg IV/IM May repeat in 5 min to max of 10 mg. OR Versed 0.1-0.2 mg/kg IV/IM May repeat in 5 min to max of 10 mg.
  60. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) – Treatment for a severe exposure after a Duodote or Mark 1 kits are available? Pg 35 & 36
    • ADULT: VALIUM: 10MG IM OR 5-10MG IV
    • OR VERSED: 2-5MG IV TITRATE TO SZ CONTROL; 5MG IN OR IM IF NO IV; REPEAT X1 IN 5 MIN TO MAX OF 10MG
    • PED: VALIUM 0.05-0.3 MG/KG IVP/ IM; MAY REPEAT IN 5 MIN TO MAX OF 10MG
    • OR VERSED 0.1-0.2 MG/KG IVP/ IM/IN. MAY REPEAT IN 5 MIN TO MAX OF 10MG
  61. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CHEMPACK (109) –Treatment for a severe exposure after 60 minutes of a Duodote or Mark 1 kits? Pg 35 & 36.
    • ATROPEN IM OR 0.1MG/KG IM/IV FROM MULTI-DOSE VIAL
    • 4KG: 0.5MG OR 0.4MG
    • 4-6.5KG: 1MG OR 0.7MG
    • 6.5-8.5KG: 1MG OR 0.9MG
    • 8.5-10.5KG: 1MG
    • 10.5-13KG: 1.5MG OR 1.3MG
    • 13-16.5KG: 2MG OR 1.6MG
    • 16.5-20.5KG: 2MG
    • 20.5-26KG: 4MG OR 2.6MG
    • 26-33KG: 4MG OR 3.3MG
    • 2PAM CHLORIDE 50MG/KG IM/IV X1. MAX OF 1650MG IM OR 1000MG IV
  62. Ambulance Destination Decision Policies and Procedures 4001 (Rev.7-11-17) - Who shall be informed of destinations decisions and ambulance assignments on an MED-ALERT?*** Pg.13
    The incident commander (IC)
  63. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- When is Transcutaneous Cardiac Pacing (TCP) used?*** pg 26
    For symptomatic bradycardia****
  64. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What is the rate for external cardiac pacing?###  pg 28
    • Rate = 80
    • mA= 50-90 adjust until capture
  65. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What can’t a paramedic transport on an inter-facility transfer?### pg 3
    Any med outside of our scope of practice###. (Unless such medication or medical procedures are self-monitored and administered by the patient or patient family members authorized by the patient physician and the transport originates within the pre-hospital phase of care.)
  66. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Can a medic transfer patients with blood products, potassium, NTG drips, and heparin drips?***  Pg 3
    • Only - Potassium not more than 40 mEq***
    • Heparin and Nitroglycerin have been discontinued as of 1-3-18 Memo
  67. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- You are working up a cardiac arrest patient in the back of the ambulance at the scene and have not began transport, base physician advises to discontinue resuscitation, what do you do?### (Cant find reference page)
    Discontinue CPR, remain at scene with patient in your ambulance until released by law enforcement agency with investigative authority or coroner.
  68. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- You receive base orders to discontinue CPR while en-route to the hospital, what do you do?### (Cant find reference page)
    Stop CPR, continue Code 2 to the closest most appropriate receiving hospital or base hospital.
  69. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- You’re in the East Kern and receive orders from a base hospital in the Bakersfield area to discontinue CPR, what do you do?### (Cant find reference page)
    Discontinue CPR, proceed Code 2 to the closest most appropriate receiving facility. Make contact with that facility ASAP and inform the ED of the situation. In this situation you’re going to transport to either, AVH, RCH or KVH and contact them with the situation.
  70. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Where do you transport a medical extremis patient?### (Amb Hospital Destination (Rev 7-11-17) pg 5
    The closest hospital ED not on closure status.
  71. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What is ALS Extremis Criteria?### Amb Hospital Destination (Rev 7-11-17) pg 5
    • Unmanageable airway or resp. arrest
    • Uncontrolled hemorrhage with signs of hypovolemic shock
    • Cardiopulmonary arrest
  72. What must the paramedic do before leaving the hospital after delivering a patient to the ED?### (UTL)
    The paramedic must leave a completed patient care report with the facility before leaving, either hand written on the county form or printed from their digital PCR device
  73. How long do you have to complete a (digital) PCR?### (UTL)Old question
    A medic has 15 hours from call time to complete digital PCR’s
  74. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- When can a patient be transported to a closed hospital ED?### Amb Hospital Destination (Rev 7-11-17) pg 5
    When the patient is in extremis status and the ED is not on internal disaster closure.
  75. Amb Hospital Destination (Rev 7-11-17) What is the purpose on an MCI activation?### pg11
    Proper management of incidents involving more than 5 patients, an incident involving a hazardous materials exposure regardless of the number of patients, and a serious or unusual overload of the EMS system as determined by the EMS Division.
  76. Trauma Policies (Rev 7-12-15) Who can activate the trauma system?### pg 4
    Fire based EMT and paramedic first responders can activate step 1 and 2 trauma activations. BLS transport EMTs can activate step 1 and 2 trauma activations. ALS and BLS transport personnel can activate step 1,2,3,4 activation but should consider consult with the trauma center before activating step 3 and 4 activations.
  77. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Where do you decompress the chest for patients with a tension pneumothorax?### pg 41
    Mid-clavicular between the 2-3rd rib (2nd intercostal space) or Mid-axilliary between the 4-5th rib (4th intercostal space).
  78. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- When is it OK to use Versed for conscious intubation?### pg 31
    Patients with Burns after the patient has been intubated.
  79. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Is it Ok to stay on-scene with a patient with a suspected MI to obtain a 12-lead?### (UTL) old question
    The Chest Pain protocol states, “do not delay treatment or transport beyond 2-3 minutes to obtain a 12-lead ECG.
  80. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Head/Eye/Ear Trauma-When is it Ok to hyperventilate a patient with head trauma?### (UTL) OLD question
    • Hyperventilation IS indicated for patients with rapid deterioration and signs of impending herniation, such as-
    • Rapidly deteriorating mental status
    • Contralateral paralysis/weakness
    • Unilateral dilated pupils
    • Decerebrate or decorticate posturing
  81. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What are the approved drugs for MADD### pg. 81
    • Narcan
    • Versed
    • Fentanyl
    • Ketamine
    • Tranexamic Acid (TXA)
    • Mag Sulfate ? Pg 64
  82. What are the contraindications of Morphine Sulfate?### (UTL) Old Question
    • Hypotension
    • Head trauma
    • Acute asthma
    • known hypersensitivity to MS
  83. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- What are the precautions of MS administration?### (UTL) Old Question
    • Elderly patients
    • Children
    • Debilitated patients
    • Have narcan readily available
  84. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Where do you perform a cricothrotomy?### (UTL)
    The cricothyroid membrane.
  85. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IV/IN/IO (206) Where do you start an IO?###
    Interosseous-proximal tibia is the only approved IO site

    The tibial-tuberosity 2’’ below the medial malleolus.
  86. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IV/IN/IO (206).What is the medication for associated pain admin of an IO.###Pg. 100
    • Lidocaine prior to saline flush.
    • 40 mg for adults slow IO
    • 0.5 mg/kg peds to 40 mg max.
  87. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IV/IN/IO (206) - What are KCEMS approved patient restraints?### Pg.98
    Commercially manufactured devices intended for patient restraint.
  88. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IV/IN/IO (206) - How much time savings is required for a patient to meet air transport criteria?### UTL Old question
    10 minutes transport time savings. (Trick question, add up flight time + onload & offload times)
  89. Paramedic Study Guide (All Provider Policies Rev 2-16-21)-What is the age cutoff for pediatric patients?### UTL Old question
    • Medical: – infant =<1, child = 1-8
    • Trauma: a Ped patient = birth to age 14
    • Adult: is 14 + 1 day
  90. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IO/IV/IN(206) - What are the contraindications of saline lock use?### Pg. 101
    If patient has a risk for hypoperfusion, (cardiac arrest, burn, or signs of physiological shock)
  91. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- IO/IV/IN(206) - What are the indications for saline lock?### Pg. 101
    A saline lock may be used for blood draw or when a patient requires intravenous access but does not require continuous infusion of an intravenous solution.
  92. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CPAP (202) - Can you administer Versed with CPAP?### pg89
    YES, IV/IO/MAD
  93. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- CPAP (202) - What are the contraindications of CPAP?### pg88
    Agonal or absent breath sounds, suspected pneumothorax or penetrating chest injury, pt. w/ tracheostomy, BP <90, aspiration risk (N/V, epistaxis, facial trauma).
  94. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- General Provisions - What meds can a paramedic transport during an interfacility transfer?### Pg.3
    Any meds within the paramedic scope of practice, even at higher doses with a physician order. Arterial lines, pre-existing thoracostomy tubes, Potassium Chloride = to or < 40 mEq, NG tubes, NTG drips. This question is written as a negative, watch the wording. What can’t a paramedic transport on an interfacility transfer?
  95. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- You have a trauma patient that’s 25-30 minutes from the trauma center via ground, the air ambulance is 15 minutes out. By what means do you transport them?### UTL Old question
    By ground, there’s no 10 min time savings Trick Question
  96. Paramedic Study Guide (All Provider Policies Rev 2-16-21)- Bradycardia (106) - What is the Bradycardic treatment protocol sequence?### Pg. 26
    • Atropine 0.5mg IV
    • TCP
    • Epinephrine Drip 2-8 mcg/min
    • Epi Push dose 0.5mL every 1-5 minutes
  97. Trauma Policy and Procedures (Rev7-1-2015)- For a level 3 activation what should the medic not do?### UTL Old question
    Utilize helicopter to transport to highest trauma facility
  98. Trauma Policy and Procedures (Rev7-1-2015)-If a doctor on scene, become primary patient care authority do they need to accompany the patient to the hospital?### UTL Old question
    Yes
  99. What classes are required by KCEMS?###UTL
    • ACLS
    • PHTLS
    • PALS
    • CPR
    • Skills Verification
  100. Trauma Policy and Procedures (Rev7-1-2015)-Who is the KCEMS medical director?### Pg.1
    Kristopher Lyons
  101. Paramedic Study Guide (All Provider Policies Rev 2-16-21)Shock/Hypoperfusion (124)- Pediatric volume resuscitation protocol for NS?### Pg 76
    Fluid resuscitation for hypovolemic shock begins with a rapid infusion of 20 ml/kg of NS (NEW)

    • (OLD) UTL  Fluid boluses may be repeated in 20 mL/kg increments up to 60 mL/kg.
    • Make base station contact for further direction if child remains hypotensive after 60 mL/kg fluid challenge without response.
  102. What is the Lasix dosage in KC?### UTL Old Question
    Not used any longer (trick question)
  103. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Pulseless Arrest Entry Algorithm (119) -Transitions in compressors should be during pulse checks, should take how long?  Pg.59
    Take < 3 seconds
  104. Paramedic Study Guide (All Provider Policies Rev 2-16-21) General Provisions - Intubation covered under what level of protocol?### Pg. UTL
    Level I
  105. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Seizure Activity (121) - What is the VERSED dose for seizures for a non pregnant patient?### pg 64
    • Versed Initial dose 5mg <40kg OR 10mg >40kg IM/IN ONLY MAX 1 mL per nare.
    • Repeat doses shall be weight based Versed 0.2mg/kg IM/IN MAX 5mg OR 0.1mg/kg IV/IO MAX 5mg.
  106. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Seizure Activity (121) - What is the Valium dose for seizures for a non pregnant patient?### pg 64
    ADULT: If Versed not available give Valium 5 mg/IV/IO if seizure lasts longer than 10 minutes may repeat dose 1-time BASE for further direction

    PEDS: Versed not available give Valium 0.3 mg/kg IV/IO MAX dose 5 mg Rectal 0.5 mg/kg. MAX dose 10 mg • If seizure lasts longer than 10 minutes may repeat dose 1 time. BASE for further direction
  107. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Tachycardia with Pulse (123) - MAGNESIUM SULFATE Pediatric dosage###Pg. 69 NEW
    • Stable Wide QRS - 25mg/kg IV/IO drip OR IVP, over 5-10 minutes.
    • Torsades - 25mg/kg diluted in 10 mL Saline IV/IO. 2 Grams MAX dose. Given 1 time only
    • Severe Respiratory Distress- 25mg/kg max 2 grams. Give over 5-10 minutes.
  108. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Acute Stroke/CVA (122) - 
    For a suspected stroke and positive Cincinnati Prehospital Stroke Scale (CPSS), how many hours since last known normal? Pg. 66
    Under 4 hours since last known normal expedite base contact and transport to appropriate facility.
  109. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Acute Stroke/CVA (122)Patient has a CVA and SPO2 is at 99%, how much oxygen do you give?### Pg. 66
    None (Apply O2 only if pulse ox <94% or signs of respiratory distress.)
  110. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Continuous Positive Airway Pressure (202) - All patients in respiratory distress can use CPAP?### Pg 88
    False
  111. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Asystole/ PEA (104) - In cardiac arrest How do you administer EPI?### NEW Pg.22
    Epinephrine IV drip 2-8 mcg/min repeat as needed. Start at 8mcg/min and titrate down once ROSC is achieved.
  112. Paramedic Study Guide (All Provider Policies Rev 2-16-21) DESTINATION DECISION SUMMARY - How many extremist criteria are there?### Pg.9
    Two, (medical and trauma)
  113. Paramedic Study Guide (All Provider Policies Rev 2-16-21) What meds can be administered though the ET tube?###
    None, no longer allowed
  114. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Spinal Motion Restriction (204) - What is the approved method for C-spine?### pg 96
    • C-Collar) and gurney straps or seatbelts only. Head blocks may be used to prevent rotation.
    • No backboards
  115. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Spinal Motion Restriction (204) - When may you leave a patient on a backboard?### pg 96
    When removing patient from device interferes with critical treatments or interventions.
  116. Paramedic Study Guide (All Provider Policies Rev 2-16-21)Chest Pain (110) - What are the contra-indications for Nitro?### pg 39
    • Suspected or known that the patient has taken sildenafil (Viagra) or vardenafil (Levitra) within the previous 24 hours or tadalafil (Cialis) within the previous 48 hours.
    • • ALS: Systolic blood pressure less than 90 mm Hg or heart rate less than 50 beats per minute.
    • • BLS: Systolic blood pressure less than 100 mm Hg or heart rate less than 50 beats per minute. Due to lack of IV access.
    • • BLS: Not prescribed to patient.
  117. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Combative Patient Restraint (205) - What is the approved drug for restraining a patient?### pg 69
    Versed 5mg IM or 2mg IV base contact required beyond initial dose for agitation control.
  118. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Where is an EMS Satelite Stroke Center?###
    There is not one
  119. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Tachycardia with Pulse (123) - What is not a serious sign or symptom of infant tachycardia?### Pg.70
    Insomnia
  120. Paramedic Study Guide (All Provider Policies Rev 2-16-21) What is the max dose of Atropine in Cardiac Arrest?###
    Atropine is no longer used
  121. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Poisoning/Ingestion/Overdose (118) - What is the antidote for Beta Blockers?### Pg 56
    Glucagon- Adults 2mg IV/IO, PEDS 0.1mg/kg slow IV/IO
  122. Paramedic Study Guide (All Provider Policies Rev 2-16-21) Poisoning/Ingestion/Overdose (118) - What is the antidote for Tricyclic Antidepressants?### Pg.57
    Sodium Bicarb - 1MeQ/kg IV/IO
  123. When can you not take a step 1 or 2 trauma patient to a Level 2 trauma center?### UTL Old question
    You must make contact with the Level 2 Trauma Center and get their input on the destination decision
  124. Who is ultimately responsible for aircraft safety?
    2021 answer not yet referenced
    The Pilot
Author
sdrake99
ID
344417
Card Set
KCEMS Protocol Study Guide 2021
Description
Paramedic Study Guide
Updated

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